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ICD-10 Guide
ICD-10 CodesS72.421

S72.421

Billable

Displaced fracture of lateral condyle of right femur

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/25/2025

Code Description

ICD-10 S72.421 is a billable code used to indicate a diagnosis of displaced fracture of lateral condyle of right femur.

Key Diagnostic Point:

A displaced fracture of the lateral condyle of the right femur is a specific type of fracture that occurs in the distal femur, affecting the outer portion of the femoral condyle. This injury is often the result of high-energy trauma, such as falls or vehicular accidents, and can lead to significant complications if not treated appropriately. The lateral condyle is critical for knee stability and function, and fractures in this area can disrupt the knee joint's biomechanics. Symptoms typically include localized pain, swelling, and inability to bear weight on the affected leg. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which reveal the fracture's displacement and any associated soft tissue injuries. Treatment often involves surgical intervention to realign the bone fragments, stabilize the fracture, and restore knee function. Post-operative rehabilitation is crucial for recovery, focusing on restoring range of motion and strength to prevent long-term complications such as osteoarthritis or joint instability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires precise documentation of fracture type and location.
  • Differentiation between displaced and non-displaced fractures.
  • Potential for associated injuries to the knee joint.
  • Variability in treatment approaches affecting coding.

Audit Risk Factors

  • Inadequate documentation of fracture details.
  • Failure to specify laterality (right vs. left).
  • Misclassification of fracture type (displaced vs. non-displaced).
  • Lack of imaging reports to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative notes.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or trauma requiring surgical intervention.

Billing Considerations

Ensure that all surgical procedures are documented, including fixation methods and any complications.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture repair to regain mobility and strength.

Billing Considerations

Documenting the patient's progress and any complications that may affect rehabilitation.

Coding Guidelines

Inclusion Criteria

Use S72.421 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate coding based on the documentation provided
  • Include specific details about the fracture's displacement and laterality
  • displaced fractures or fractures of other femoral regions

Exclusion Criteria

Do NOT use S72.421 When
  • Exclude codes for non

Related ICD-10 Codes

Related CPT Codes

27506CPT Code

Open treatment of femoral condyle fracture

Clinical Scenario

Used in conjunction with S72.421 for surgical repair.

Documentation Requirements

Operative report detailing the procedure performed.

Specialty Considerations

Orthopedic surgeons must document the surgical approach and fixation method.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S72.421 provides a clear distinction between types of fractures, which is essential for treatment planning and outcomes assessment.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S72.421 provides a clear distinction between types of fractures, which is essential for treatment planning and outcomes assessment.

Reimbursement & Billing Impact

reimbursement processes. S72.421 provides a clear distinction between types of fractures, which is essential for treatment planning and outcomes assessment.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between S72.421 and S72.420?

S72.421 refers to a displaced fracture of the lateral condyle of the right femur, while S72.420 refers to a non-displaced fracture of the same area. Accurate documentation of the fracture type is crucial for correct coding.